Rabu, 30 November 2011
What is Perimenopause?
Perimenopause, often referred to as pre-menopause or menopausal transition, is the time when natural changes occur in the body that lead to permanent infertility, or menopause. These changes usually begin to occur when a woman is in her 40's, however some women can experience it as early as their 30's. Once a woman goes 12 months consecutively without a period, menopause is reached and perimenopause is over. On average, women reach menopause at age 51.
The most common symptoms of perimenopause are menstrual irregularity, hot flashes, bone density loss, decreasing fertility, mood changes, sleep problems, vaginal dryness and infections, and bladder problems. If a woman experiences symptoms that interfere with her life or well-being, it is important that she make and appointment to visit her doctor.
Available treatments you can ask your doctor about include oral contraceptives, laser treatment to reduce or end menstrual flow, and progestin therapy. At home, it is important that women eat a nutritious diet, get regular exercise, and practice stress reduction techniques.
Perimenopause and menopause is a normal phase in a woman’s life, however, if you ever have questions or concerns, please don’t hesitate to ask questions!!!
For more information on perimenopause and/or menopause, please ask your doctor, or log onto www.evchc.org to find out how to make an appointment at one of our clinics.
The most common symptoms of perimenopause are menstrual irregularity, hot flashes, bone density loss, decreasing fertility, mood changes, sleep problems, vaginal dryness and infections, and bladder problems. If a woman experiences symptoms that interfere with her life or well-being, it is important that she make and appointment to visit her doctor.
Available treatments you can ask your doctor about include oral contraceptives, laser treatment to reduce or end menstrual flow, and progestin therapy. At home, it is important that women eat a nutritious diet, get regular exercise, and practice stress reduction techniques.
Perimenopause and menopause is a normal phase in a woman’s life, however, if you ever have questions or concerns, please don’t hesitate to ask questions!!!
For more information on perimenopause and/or menopause, please ask your doctor, or log onto www.evchc.org to find out how to make an appointment at one of our clinics.
Senin, 28 November 2011
Selasa, 22 November 2011
Kamis, 17 November 2011
Christmas Holiday Toy Drive
The holidays are almost here and East Valley Pomona and West Covina
If you are able to help one or more of the identified patients, please bring an unwrapped toy to the front desk of either the Pomona or West Covina
C/O Shawna Maliglig
Please write “Christmas” on the memo line of your check.
I understand that economically it is a difficult time, however these patients and their families would not have any Christmas gifts if it were not for the spirit of giving. Thank you for making the holidays a little brighter for those in need.
Selasa, 15 November 2011
5-Ways East Valley Helps Everyone in the Community:
1. East Valley
2. East Valley
3. East Valley
4. East Valley
5. East Valley
Senin, 14 November 2011
Round 2 Recipe -Thanksgiving Quesadilla with Cranberry Cream Dipping Sauce on the Food Network
Round 2 Recipe -Thanksgiving Quesadilla with Cranberry Cream Dipping Sauce on the Food Network
This is a good recipe for after Thanksgiving snacks. Substitute regular sour cream for fat-free or light sour cream and use low-fat cheese to make it a bit healthier. Enjoy!
This is a good recipe for after Thanksgiving snacks. Substitute regular sour cream for fat-free or light sour cream and use low-fat cheese to make it a bit healthier. Enjoy!
Why get tested?
There are many reasons to get an HIV test. A few are:
• You’re sexually active and are concerned about your health.
• You’ve had unprotected oral, vaginal, or anal sex.
• You and your sexual partner(s) want to know each other’s status.
• You’ve had a sexual partner who is HIV positive.
• You have injected drugs or other substances.
• You just want to know.
East Valley provides HIV education, testing, counseling, and case management to those in need. To help us continue to provide these vital services, please click on the donate button at the top of the page or log onto www.evchc.org. Thank you in advance for your contribution!
• You’re sexually active and are concerned about your health.
• You’ve had unprotected oral, vaginal, or anal sex.
• You and your sexual partner(s) want to know each other’s status.
• You’ve had a sexual partner who is HIV positive.
• You have injected drugs or other substances.
• You just want to know.
East Valley provides HIV education, testing, counseling, and case management to those in need. To help us continue to provide these vital services, please click on the donate button at the top of the page or log onto www.evchc.org. Thank you in advance for your contribution!
Selasa, 08 November 2011
Cancer Symptoms
20 Cancer Symptoms Women Are Most Likely to Ignore
By Melanie Haiken, Caring.com senior editor
Routine tests like pap smears and mammograms are important, but don't rely on tests alone to protect you from cancer. It's just as important to listen to your body and notice anything that's different, odd, or unexplainable. Although many of these symptoms could be caused by less serious conditions, they're worth getting checked out if they persist. You don't want to join the ranks of cancer patients who realize too late that symptoms they'd noticed for a long time could have sounded the alarm earlier, when cancer was easier to cure.
1. Wheezing or shortness of breath
One of the first signs lung cancer patients remember noticing when they look back is the inability to catch their breath. "I couldn't even walk across the yard without wheezing. I thought I had asthma, but how come I didn't have it before?" is how one woman described it. Thyroid cancer can also cause breathing problems if a nodule or tumor begins to press on the trachea, or windpipe. Any breathing difficulties that persist are reason to visit the doctor.
2. Chronic cough or chest pain
Several types of cancer, including leukemia and lung tumors, can cause symptoms that mimic a bad cough or bronchitis. One way to tell the difference: The problems persist, or go away and come back again in a repeating cycle. Some lung cancer patients report chest pain that extends up into the shoulder or down the arm.
3. Swallowing problems or hoarseness
Most commonly associated with esophageal or throat cancer, difficulty swallowing is sometimes one of the first signs of lung cancer, too. A hoarse or low, husky voice or the feeling of something pressing on the throat can be an early indicator of thyroid cancer or a precancerous thyroid nodule, as can the feeling of having something stuck in your windpipe.
4. Frequent fevers or infections
These can be signs of leukemia, a cancer of the blood cells that starts in the bone marrow. Leukemia causes the marrow to produce abnormal white blood cells, which crowd out healthy white cells, sapping the body's infection-fighting capabilities. Often, doctors diagnose leukemia only after the patient has been in a number of times complaining of fever, achiness, and flu-like symptoms over an extended period of time.
5. Swollen lymph nodes or lumps on the neck, underarm, or groin
Enlarged lymph nodes indicate changes in the lymphatic system, which can be a sign of cancer. For example, a lump or an enlarged lymph node under the arm is sometimes a sign of breast cancer. A painless lump on the neck, underarm, or groin can be an early sign of leukemia.
6. Bloating or abdominal weight gain -- the "my jeans don't fit" syndrome
While this might sound too common a phenomenon to be considered a cancer symptom, consider this: Women diagnosed with ovarian cancer overwhelmingly report that unexplained abdominal bloating that came on fairly suddenly and continued on and off over a long period of time (as opposed to occurring a few days each month with PMS) was one of the main ways they knew something was wrong.
7. Feeling full and unable to eat
This is another tip-off to ovarian cancer; women say they have no appetite and can't eat, even when they haven't eaten for some time. Any woman who experiences noticeable bloating or weight gain numerous times (the diagnostic criteria is more than 13 times over the period of a month) -- especially if it's accompanied by pelvic pain or feeling overly full -- should call her doctor and ask for a pelvic ultrasound.
8. Pelvic or abdominal pain
Taken by itself, pelvic pain can mean a lot of things. In fact, because it's a common symptom of fibroids, ovarian cysts, and other reproductive tract disorders, doctors don't always think of cancer when you describe pelvic pain. Make sure your doctor looks at all possible explanations and does a full exam, since pain and cramping in the pelvis and abdomen can go hand in hand with the bloating that often signals ovarian cancer. Leukemia can also cause abdominal pain resulting from an enlarged spleen.
9. Unusually heavy or painful periods or bleeding between periods
Many women reported this as the tip-off to endometrial or uterine cancer. Unfortunately, many women also said their doctors weren't responsive, overlooking or misdiagnosing their complaints as normal perimenopause. Ask for a transvaginal ultrasound if you suspect something more than routine heavy periods.
10. Rectal bleeding or blood in stool
"I thought it was hemorrhoids" is one of the most common things doctors hear when diagnosing colorectal cancer. Blood in the toilet alone is reason to call your doctor and schedule a colonoscopy.
Retrieved from: http://health.msn.com/health-topics/cancer/20-cancer-symptoms-women-are-most-likely-to-ignore
East Valley provides early cancer detection services to men and women. Many people who come to the clinic have little to no income and need services like ours. To help East Valley continue to provide these services for those in need, please click donate on our blog. For more information about our services, please visit us at http://www.evchc.org/. Thank you for your support!
Sexually Transmitted Disease Facts
- Chlamydia is the #1 STD among teens.
- Chlamydia, Gonnorhea, and Syphilis are all curable but if they are not treated in time could lead to long-term health problems including infertility, blindness, and even death.
- Condoms should be worn during every sexual act and protect against most STDs.
- A mother with an STD can pass it to their baby during childbirth.
- There are two types of Herpes, 1 & 2, and most people have type 1 which are commonly known as cold sores or fever blisters.
- Some strains of HPV cause genital warts, and others can cause cervical cancer. Although the warts can be ugly, the HPV that causes cervical cancer is much more serious.
- You don't have to "sleep around" to get an STD, because many people can get it from a cheating partner or from the first time they have sex. It only takes one time!
Senin, 07 November 2011
Judge blocks graphic cigarette label images
Very interesting article about the FDA trying to mandate disturbing images on cigarette packages. If you get a chance, read the comments after the article too!
Judge blocks graphic cigarette label images
Judge blocks graphic cigarette label images
Minggu, 06 November 2011
A testimony from Sophal
So the soldiers, their officer, and the Jewish police arrested Jesus and bound him. ~~ John 18:12"Many people who thought I died during Pol Pot are just to know I am alive," Mrs. Sophal shared with me about re-connecting with friends in the Battambong region where she traveled to conduct a workshop in leadership development for the CHAD program of the Methodist Mission in Cambodia. She and I are driving to another church visit when she received a call from one of these friends.
"Commit your cause to the LORD; let him deliver-- let him rescue the one in whom he delights!" ~~ Psalm 22:8
"We got separated and they thought I had died like my brother."
Mrs. Sophal's brother was a Christian (the only one in her family, and one of very few in Cambodia) before the Khmer Rouge took over the country. He was captured and executed by the Pol Pot regime. The way she tells the story is thus. "They bound his hands, but only loosely. So, he was able to escape a bit to the forest where he prayed before they killed him."
She continues the story by saying that mental illness is a burden for people in Cambodia, especially women. "Women can't release their burden, they just keep thinking, and this causes mental problem. Many times during Pol Pot, I wanted to kill myself, but I thought about my younger sister, what would happen to her if I died." Today, Mrs. Sophal says she can release her burdens through prayer modeled by her brother and by Jesus. She shares this faith with others in Cambodia, with the hope that they can also find release.
Mrs. Sophal's own conversion happened much later, in response to God answering her prayers for healing the sight of man in her community development project. But, the inspiration of her brother, his faith and his prayers, helped to shape her and her understanding that even in the Garden of Gethsemane, we can cast our burdens upon God and find freedom.
by Katherine Parker
A devotional reflection for Good Friday Year B
Jumat, 04 November 2011
FDA: Moldy applesauce repackaged by school lunch supplier
I came accross this article and thought it might be of interest to some of you.
FDA: Moldy applesauce repackaged by school lunch supplier
FDA: Moldy applesauce repackaged by school lunch supplier
A first-hand account of flooding in Prey Veng Province from Amanda
by Amanda King
The enormity of this year's flooding was really driven home to me when I (Amanda King) traveled with a friend to visit his home village during the recent Pchum Ben holiday. My friend's home is in Prey Veng Province, along the Mekong River and near the Vietnam border.
Recently, I've learned to love the wide-open view that comes with traveling the country by moto, as we were last week — and as most Cambodians do on a daily basis. This time, though, that view afforded me a front-row seat to a natural disaster.
The farther we got out of the city, the closer we got to the river; and as the kilometers went by, the extent of the flooding gradually unfolded.
What started out as flooded ditches and over-saturated rice paddies slowly morphed into an inland ocean, until all that was to be seen on either side of the highway was water stretching all the way to the horizon, with the occasional rooftop or palm tree interrupting the otherwise glassy surface.
We rode several kilometers through this surreal and deceptively serene landscape before we got a glimpse of the human cost of the flooding. Soon enough, we started noticing the people — lots of them — all along the sides of the road. But they weren't walking or waiting to snag a ride. They were living there. On the shoulder of the road. People, cows, chickens, ducks. All huddled beneath tarps or in wobbly lean-tos. Entire villages were popping up in the two meters or so of concrete along the side of the road — the only dry ground to be seen for kilometers.
The scene continued like this for almost an hour's worth of driving, and the closer we got to my friend's home, the more clear it became that his village would likely be among the many affected by this catastrophe.
When we pulled off the national highway and onto the dirt road that leads to my friend's home village, we made it less than 20 meters before we were brought to a stop by the sight of water over the road.
The water here wasn't too deep — just under two feet, by my estimation — but it was enough that it would have drowned out the moto's engine if we were to continue. So we parked the bike at a relative's home nearby and set out to finish the final five kilometers of the journey on foot, rolling up our pant legs and sloshing through the filthy, trash-ridden water from the swollen river.
We walked less than a half kilometer like this before we made it back to dry ground, but when we got within two kilometers of his home, we ran head-on into the river. There was no road anymore. Just river. (I should interject here that this particular road was well over 150 meters away from the river when I visited last month.)
A dugout canoe was the only means of transport available to us at this point, so into the boat we went. By the time my friend, myself, and the boat owner were all loaded, the top of the canoe was a mere one or two inches above the surface of the water, and even the slightest movement rocked the boat in a way that threatened to spill us all overboard. Needless to say, I sat completely still, with my mouth slightly ajar, as we paddled past homes I had visited just the month before, now with water a meter deep encroaching on their stilted frames. Within 10 minutes, we had arrived at my friend's village. We paddled in through the "backyard" of his aunt's house, past the halfway submerged outhouse and right up to within two meters of the home.
His aunt had a bit of dry ground in the yard in front of her stilted house, so it was therefore the de-facto home for all the livestock in the village as well as the site of the big party requisite for the last night of the festival. We stayed in the village for three days and two nights, and by the time we left, she would have no front yard to speak of, as the town would essentially become part of the river. Even the dugout canoe we had taken there would not be enough to get us back, now that there was a strong current flowing down what used to be the village's only road. We would resort to taking a larger fishing boat with an engine.
Villagers who had lived in the area for more than 50 years were saying it was the worst flooding they had ever seen.
I've never really been thrown into the middle of a natural disaster like this before. The rising waters complicated almost every aspect of daily life: cooking, bathing, using the toilet, walking to visit a neighbor. But some things were simplified, believe it or not. Fishing, for instance, was now merely a matter of setting up a net outside the front door and checking it occasionally.
By and large, though, it just made everything harder, and will continue to do so as hundreds of thousands of hectares of rice are ruined and unsanitary floodwater spreads waterborne illness. That's not to mention the role scientists are saying lingering pools of standing water will play in extending the season for mosquito-borne illnesses like dengue fever and malaria.
The flood, and its consequences, are tough to ignore for all of our staff here in Cambodia who have seen it first-hand. Thankfully, my fellow missionaries and I have the means to leave the disaster behind, but that's quite simply not the case for most of those affected.
By Amanda King, Individual Volunteer assisting with communications for the Methodist Mission in Cambodia
Kamis, 03 November 2011
Health Care Reform (2)
Accountable Care Organizations: Improving Care Coordination for People with Medicare
The Affordable Care Act includes a number of policies to help physicians, hospitals, and other caregivers improve the safety and quality of patient care and make health care more affordable. By focusing on the needs of patients and linking payments to outcomes, these delivery system reforms will help improve the health of individuals and communities and slow cost growth.
On March 31, 2011, the Department of Health and Human Services (HHS) released proposed new rules to help doctors, hospitals, and other providers better coordinate care for Medicare patients through Accountable Care Organizations (ACOs). ACOs create incentives for health care providers to work together to treat an individual patient across care settings – including doctor’s offices, hospitals, and long-term care facilities. The Medicare Shared Savings Program will reward ACOs that lower growth in health care costs while meeting performance standards on quality of care and putting patients first. Patient and provider participation in an ACO is purely voluntary.
Need for and Benefits of Coordinated, Accountable Care
Today, more than half of Medicare beneficiaries have five or more chronic conditions such as diabetes, arthritis, hypertension, and kidney disease. These patients often receive care from multiple physicians. A failure to coordinate care can often lead to patients not getting the care they need, receiving duplicative care, and being at an increased risk of suffering medical errors. On average, each year, one in seven Medicare patients admitted to a hospital has been subject to a harmful medical mistake in the course of their care. And nearly one in five Medicare patients discharged from the hospital is readmitted within 30 days – a readmission many patients could have avoided if their care outside of the hospital had been aggressive and better coordinated.
Improving coordination and communication among physicians and other providers and suppliers through Accountable Care Organizations will help improve the care Medicare beneficiaries receive, while also helping lower costs.
According to the analysis of the proposed regulation for ACOs, Medicare could potentially save as much as $960 million over three years.
About Accountable Care Organizations
Under the proposed rule, an ACO refers to a group of providers and suppliers of services (e.g., hospitals, physicians, and others involved in patient care) that will work together to coordinate care for the patients they serve with Original Medicare (that is, those who are not in a Medicare Advantage private plan). The goal of an ACO is to deliver seamless, high quality care for Medicare beneficiaries. The ACO would be a patient-centered organization where the patient and providers are true partners in care decisions.
The Affordable Care Act specifies that an ACO may include the following types of groups of providers and suppliers of Medicare-covered services:
Sharing Savings
Under the proposed rule, Medicare would continue to pay individual health care providers and suppliers for specific items and services as it currently does under the Original Medicare payment systems. CMS would also develop a benchmark for each ACO against which ACO performance is measured to assess whether it qualifies to receive shared savings, or to be held accountable for losses. CMS is also proposing to establish a minimum sharing rate that would account for normal variations in health care spending, so that the ACO would be entitled to shared savings only when savings exceeded the minimum sharing rate. The amount of shared savings depends on whether on an ACO meets or exceeds quality performance standards. The proposed rule would provide for additional shared savings for ACOs that include beneficiaries who receive services from a Federally Qualified Health Center or Rural Health Clinic during the performance year.
CMS is proposing to implement both a one-sided risk model (sharing of savings only for the first two years and sharing of savings and losses in the third year) and a two-sided risk model (sharing of savings and losses for all three years), allowing the ACO to opt for either model. This will help organizations with less experience with risk models, such as some physician-driven organizations or smaller ACOs, to gain experience with population management before transitioning to a risk-based model, while also providing an opportunity for more experienced ACOs that are ready to share in losses to enter a sharing arrangement that provides a greater share of savings, but at the risk of repaying Medicare a portion of any losses.
Measuring Quality Improvement
The proposed rule links the amount of shared savings an ACO may receive to its performance on quality standards. The rule proposes quality measures in five key areas that affect patient care:
Improving Care for Patients
Any patient who has multiple doctors probably understands the frustration of fragmented and disconnected care: lost or unavailable medical charts, duplicated medical procedures, or having to share the same information over and over with different doctors. Accountable Care Organizations are designed to lift this burden from patients, while improving the partnership between patients and doctors in making health care decisions. People with Medicare will have better control over their health care, and their doctors can provide better care because they will have better information about their patients’ medical history and can communicate with a patient’s other doctors. Medicare beneficiaries whose doctors participate in an ACO will still have a full choice of providers and can still choose to see doctors outside of the ACO. Patients choosing to receive care from providers participating in ACOs will have access to information about how well their doctors, hospitals, or other caregivers are meeting quality standards.
Antitrust Guidance for Providers in ACOs
The Department of Justice (DOJ) and the Federal Trade Commission (FTC) have worked together to facilitate the creation of ACOs by giving providers the clear and practical guidance they need to form innovative, integrated health care delivery systems without running afoul of antitrust laws. In conjunction with the proposed rule for the Shared Savings Program, the two agencies have issued a joint Proposed Statement of Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program (“Antitrust Policy Statement”). Under the proposed Antitrust Policy Statement, the agencies are proposing to establish different levels of antitrust scrutiny depending on the specific ACO arrangement. For example, DOJ and FTC are proposing to give rule of reason treatment to an ACO if, the ACO uses the same governance and leadership structure and the same clinical and administrative processes in the commercial market, as it uses to qualify for and participate in the Shared Savings Program. For more details, visit www.ftc.gov/opp/aco/.
One Part of Quality Improvement
ACOs are just one piece of a broader effort by the Obama Administration to improve the quality of health care for all Americans. On March 21, HHS announced the first-ever National Quality Strategy, which will serve as a tool to better coordinate quality initiatives between public and private partners. In addition, the Affordable Care Act established a new Center for Medicare and Medicaid Innovation that will test innovative care and service delivery models. CMS is currently exploring how the Innovation Center will test alternative payment models for Accountable Care Organizations.
Before the rule is finalized, CMS will review all comments from the public and may make changes to its proposals based on those comments.
To read the Notice of Proposed Rule-making for ACOs, visit http://www.ofr.gov/inspection.aspx?AspxAutoDetectCookieSupport=1.
To read the press release, visit http://www.hhs.gov/news/press/2011pres/03/20110331a.html.
Posted on: March 31, 2011
Last updated: October 26, 2011
http://www.healthcare.gov/news/factsheets/2011/03/accountablecare03312011a.html
On March 31, 2011, the Department of Health and Human Services (HHS) released proposed new rules to help doctors, hospitals, and other providers better coordinate care for Medicare patients through Accountable Care Organizations (ACOs). ACOs create incentives for health care providers to work together to treat an individual patient across care settings – including doctor’s offices, hospitals, and long-term care facilities. The Medicare Shared Savings Program will reward ACOs that lower growth in health care costs while meeting performance standards on quality of care and putting patients first. Patient and provider participation in an ACO is purely voluntary.
Need for and Benefits of Coordinated, Accountable Care
Today, more than half of Medicare beneficiaries have five or more chronic conditions such as diabetes, arthritis, hypertension, and kidney disease. These patients often receive care from multiple physicians. A failure to coordinate care can often lead to patients not getting the care they need, receiving duplicative care, and being at an increased risk of suffering medical errors. On average, each year, one in seven Medicare patients admitted to a hospital has been subject to a harmful medical mistake in the course of their care. And nearly one in five Medicare patients discharged from the hospital is readmitted within 30 days – a readmission many patients could have avoided if their care outside of the hospital had been aggressive and better coordinated.
Improving coordination and communication among physicians and other providers and suppliers through Accountable Care Organizations will help improve the care Medicare beneficiaries receive, while also helping lower costs.
According to the analysis of the proposed regulation for ACOs, Medicare could potentially save as much as $960 million over three years.
About Accountable Care Organizations
Under the proposed rule, an ACO refers to a group of providers and suppliers of services (e.g., hospitals, physicians, and others involved in patient care) that will work together to coordinate care for the patients they serve with Original Medicare (that is, those who are not in a Medicare Advantage private plan). The goal of an ACO is to deliver seamless, high quality care for Medicare beneficiaries. The ACO would be a patient-centered organization where the patient and providers are true partners in care decisions.
The Affordable Care Act specifies that an ACO may include the following types of groups of providers and suppliers of Medicare-covered services:
- ACO professionals (i.e., physicians and hospitals meeting the statutory definition) in group practice arrangements,
- Networks of individual practices of ACO professionals,
- Partnerships or joint ventures arrangements between hospitals and ACO professionals, or
- Hospitals employing ACO professionals, and
- Other Medicare providers and suppliers as determined by the Secretary.
Sharing Savings
Under the proposed rule, Medicare would continue to pay individual health care providers and suppliers for specific items and services as it currently does under the Original Medicare payment systems. CMS would also develop a benchmark for each ACO against which ACO performance is measured to assess whether it qualifies to receive shared savings, or to be held accountable for losses. CMS is also proposing to establish a minimum sharing rate that would account for normal variations in health care spending, so that the ACO would be entitled to shared savings only when savings exceeded the minimum sharing rate. The amount of shared savings depends on whether on an ACO meets or exceeds quality performance standards. The proposed rule would provide for additional shared savings for ACOs that include beneficiaries who receive services from a Federally Qualified Health Center or Rural Health Clinic during the performance year.
CMS is proposing to implement both a one-sided risk model (sharing of savings only for the first two years and sharing of savings and losses in the third year) and a two-sided risk model (sharing of savings and losses for all three years), allowing the ACO to opt for either model. This will help organizations with less experience with risk models, such as some physician-driven organizations or smaller ACOs, to gain experience with population management before transitioning to a risk-based model, while also providing an opportunity for more experienced ACOs that are ready to share in losses to enter a sharing arrangement that provides a greater share of savings, but at the risk of repaying Medicare a portion of any losses.
Measuring Quality Improvement
The proposed rule links the amount of shared savings an ACO may receive to its performance on quality standards. The rule proposes quality measures in five key areas that affect patient care:
- Patient/caregiver experience of care;
- Care coordination;
- Patient safety;
- Preventive health; and
- At-risk population/frail elderly health.
Improving Care for Patients
Any patient who has multiple doctors probably understands the frustration of fragmented and disconnected care: lost or unavailable medical charts, duplicated medical procedures, or having to share the same information over and over with different doctors. Accountable Care Organizations are designed to lift this burden from patients, while improving the partnership between patients and doctors in making health care decisions. People with Medicare will have better control over their health care, and their doctors can provide better care because they will have better information about their patients’ medical history and can communicate with a patient’s other doctors. Medicare beneficiaries whose doctors participate in an ACO will still have a full choice of providers and can still choose to see doctors outside of the ACO. Patients choosing to receive care from providers participating in ACOs will have access to information about how well their doctors, hospitals, or other caregivers are meeting quality standards.
Antitrust Guidance for Providers in ACOs
The Department of Justice (DOJ) and the Federal Trade Commission (FTC) have worked together to facilitate the creation of ACOs by giving providers the clear and practical guidance they need to form innovative, integrated health care delivery systems without running afoul of antitrust laws. In conjunction with the proposed rule for the Shared Savings Program, the two agencies have issued a joint Proposed Statement of Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program (“Antitrust Policy Statement”). Under the proposed Antitrust Policy Statement, the agencies are proposing to establish different levels of antitrust scrutiny depending on the specific ACO arrangement. For example, DOJ and FTC are proposing to give rule of reason treatment to an ACO if, the ACO uses the same governance and leadership structure and the same clinical and administrative processes in the commercial market, as it uses to qualify for and participate in the Shared Savings Program. For more details, visit www.ftc.gov/opp/aco/.
One Part of Quality Improvement
ACOs are just one piece of a broader effort by the Obama Administration to improve the quality of health care for all Americans. On March 21, HHS announced the first-ever National Quality Strategy, which will serve as a tool to better coordinate quality initiatives between public and private partners. In addition, the Affordable Care Act established a new Center for Medicare and Medicaid Innovation that will test innovative care and service delivery models. CMS is currently exploring how the Innovation Center will test alternative payment models for Accountable Care Organizations.
Before the rule is finalized, CMS will review all comments from the public and may make changes to its proposals based on those comments.
To read the Notice of Proposed Rule-making for ACOs, visit http://www.ofr.gov/inspection.aspx?AspxAutoDetectCookieSupport=1.
To read the press release, visit http://www.hhs.gov/news/press/2011pres/03/20110331a.html.
Posted on: March 31, 2011
Last updated: October 26, 2011
http://www.healthcare.gov/news/factsheets/2011/03/accountablecare03312011a.html
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